US researchers have discovered a novel STD known as “Trichophyton mentagrophytes type VII.”
This is the first US account of a sexually transmitted ringworm caused by a rare fungus.
Physicians at NYU Langone Health in New York City published a case report in JAMA Dermatology on Wednesday. Clinicians throughout the globe are reporting more difficulties in managing fungal infections.
“We think a lot about antibacterial resistance, but this is a very important time for us to think about anti-fungus resistance,” said Mahmoud Ghannoum, a professor of dermatology at the Case Western Reserve University School of Medicine in Cleveland. He was not involved with the new report.
In the latest example, a thirty-year-old male from New York City claimed to have had intercourse with several men while traveling to England, Greece, and California. He had a red, itchy rash on his legs, over his crotch, and across his buttocks when he returned home.
Tests showed he had Trichophyton mentagrophytes type VII, a sexually transmitted fungal infection. This marks the initial identification of the fungus in the United States. Thirteen such cases were documented by French doctors last year. Men who have intercourse with men made up twelve of the patients.
Standard antifungal drugs helped to treat the American man’s infection, but it took four and a half months for it to completely recover. He was given fluconazole for four weeks without showing any signs of improvement, followed by terbinafine for six weeks and itraconazole for roughly eight more weeks.
Each one is an oral antifungal. There were no additional infections in him that could have exacerbated the issue.
Dr. Avrom Caplan, an assistant professor of dermatology at the NYU Grossman School of Medicine and author of the new report, said the case should raise awareness but not cause alarm in the general public.
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“There’s no evidence that this is widespread, or that this is something that people really need to be worried about,” he said. “But if people are having itchy eruptions in areas like the groin, and it’s not getting better, see a doctor.”
Rash may look like eczema
While the infection was most likely transmitted through sexual contact, Caplan couldn’t rule out the possibility that the man acquired the fungus at a sauna he’d visited two months prior to his symptoms. The man said his sexual partners did not show any signs of ringworm.
Caplan said the rash may look more like an eczema flare than typical ringworm infections that form in circles. The infection is not life-threatening, but can cause permanent scarring.
He previously identified the first two cases of a different ringworm infection in 2023. Those infections, caused by Trichophyton indotineae, are not considered STIs but are drug-resistant and highly contagious.
Since then, Caplan’s team at NYU Langone Health has identified a total of 11 cases of Trichophyton indotineae ringworm in both men and women in New York City.
The new case report is “notable” said Jeremy Gold, a medical epidemiologist at the Centers for Disease Control and Prevention. He stressed that doctors should consider fungi along with viruses and bacteria as a potential cause of sexually transmitted disease.
“Oftentimes, what happens is that these patients receive multiple courses of antibacterial drugs which are not going to make the fungus better,” he said.
“Clinicians should keep this in mind so that patients can get appropriate care.” He was not involved in the new case report.
Caplan also encouraged people to speak up and seek out treatment. For now, Trichophyton mentagrophytes type VII is treatable.
“If you have a rash or lesions on your skin that aren’t getting better, and you think it might be ringworm,” he said, “see your doctor.”
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